title: Lymphaticovenous anastomosis for facial lymphoedema after multiple courses of therapy for head-and-neck cancer.
abstract: Lymphaticovenous anastomosis (LVA) is a treatment for lymphoedema that can improve lymph circulation by the anastomosis of lymph vessels and veins. A therapeutic effect of LVA for lymphoedema has been shown in limbs, but efficacy for other regions has not been shown. Lymphoedema in the head-and-neck region following cancer resection and radiotherapy is mainly treated with manual lymphatic drainage. However, there is no alternative when this treatment is ineffective because application of compression treatment using a bandage is difficult in this region. We used LVA for lymphoedema in the head-and-neck region and achieved a good outcome. Functional and dilating lymph vessels were identified using pre- and intra-operative fluorescent lymphography, and a lymph vessel with a diameter of about 0.2-1.0 mm was anastomosed with a vein using supermicrosurgery. The outcome of this case suggests that LVA is applicable for treatment of lymphoedema in the head-and-neck region.
authors.affiliation: Department of Plastic Surgery and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. mihara@keiseigeka.name
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Gentaro
authors.initials: G
authors.lastname: Uchida
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Moriguchi
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000714:Anastomosis, Surgical; D005145:Face; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D008209:Lymphedema / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects; D014680:Veins / Q000601:surgery*